脑胶质瘤患者MRS脑代谢物浓度与FA值相关性分析

Analysis of Correlation between MRS Brain Metabolite Concentration and FA Value in Patients with Glioma

目的分析脑胶质瘤患者脑中不同区域的代谢物浓度及FA值相关性。方法前瞻性纳入临床疑似脑胶质瘤患者110例,MR检查后,经开颅手术或穿刺获得病理诊断结果,将71例确诊为脑胶质瘤患者作为研究对象,对所有患者脑中瘤体区、周围水肿区及周围正常脑白质区进行1H-MRS和DTI扫描,以Spectroscopy软件于各区域取1~7个体素,检测各体素内N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)浓度,计算NAA/Cr、Cho/Cr比值,以Viewing软件选取与各1H-MRS体素相对应位置的ROI,测量各ROI内FA均值。观察比较患者脑内不同区域NAA、Cho、Cr水平,NAA/Cr、Cho/Cr比值及FA值差异,并对各区域NAA、Cho、Cr、NAA/Cr、Cho/Cr与FA值相关性进行研究。结果瘤体区和水肿区NAA、Cho、NAA/Cr、Cho/Cr及FA值与正常区域相比均有显著差异(P<0.05),与水肿区相比,瘤体区NAA、NAA/Cr显著降低,Cho、Cho/Cr显著升高(P<0.05),Cr和FA值无差异(P>0.05);患者瘤体区NAA、NAA/Cr与FA值呈显著正相关,水肿区NAA、Cho和Cho/Cr与FA值呈显著正相关,正常区域NAA、NAA/Cr与FA呈显著正相关(P<0.05)。结论瘤体内NAA、NAA/Cr与FA值呈显著正相关,水肿区NAA、Cho和Cho/Cr与FA值呈显著正相关,1H-MRS和DTI可联合用于脑胶质瘤的检测,为无创性研究脑胶质瘤代谢特点及微观结构提供一定的基础。

Objective To analysis the relationship between metabolite concentration and FA value in different regions of brain glioma patients was analyzed. Methods A prospective study was conducted in 110 patients with clinically suspected glioma,71 cases were diagnosed with glioma patients as a research object according to the craniotomy or puncture to obtain pathological diagnosis results after MR examination.1H-MRS and DTI scans were performed in all patients with brain tumor area,surrounding edema area and surrounding normal white matter area.NAA,Cho,Cr,NAA/Cr and Cho/Cr in each voxel were measured by Spectroscopy software,The ROI of each position corresponding to each 1H-MRS voxel was selected by Viewing software,and the mean value of FA in each ROI was measured.The levels of NAA,Cho,Cr,NAA/Cr,Cho/Cr ratio and FA were compared in different regions of the patients.And the correlation between NAA,Cho,Cr,NAA/Cr,Cho/Cr and FA in each region was studied. Results NAA,Cho,NAA/Cr,Cho/Cr and FA of the tumor area and edema area were significantly different from those in the normal area （ P 〈0.05）;Compared with the edema area,NAA,NAA/Cr decreased significantly,Cho and Cho/Cr were significantly increased （ P 〈0.05）,but there was no difference between Cr and FA （ P 〉0.05）;There was a significant positive correlation between NAA,NAA/Cr and FA in the tumor area,NAA,Cho and Cho/Cr and FA in the edema area,NAA and NA and FA in normal area （ P 〈0.05）. Conclusion There were significant positive correlations between NAA,NAA/Cr and FA in the tumor,and NAA,Cho and Cho/Cr in the edema area were positively correlated with FA.1H-MRS and DTI can be used for the detection of glioma,and provide a basis for noninvasive study of metabolic characteristics and microstructure of glioma.